senior medical billing specialist resume example with 8+ years of experience

(555) 432-1000,
, , 100 Montgomery St. 10th Floor

Organized Medical Biller thoroughly versed in medical coding and HIPAA requirements. Personable professional with 10+ years of hands-on experience claiming refunds, reviewing claims and maintaining billing reports.

Accommodating and helpful team player proficient in job-related billing software. Successful Pharmacy Technician bringing 10+ years of experience in filling prescriptions with expert accuracy, building relationships with customers and promoting teamwork within pharmacy settings. Knowledgeable about regulatory guidelines and policies governing fraud, waste and abuse.

  • HIPAA Compliance Certification
  • Billing and Collection Procedures
  • Chart Auditing
  • Commercial and Private Insurance
  • Medical Terminology
  • Account Reconciliation
  • Verbal and Written Communication
  • Information Confidentiality
  • Records Management
  • Claims Processing
  • Medical Transcription
  • Billing Data Verification
  • Discrepancy Resolution
  • Drug Inventory Control
  • Point of Sale Systems Proficiency
  • Customer Service
  • Detail-Oriented
  • Medication Documentation
  • FDA Compliance
  • Insurance Verification
  • Insurance Billing
  • Account Posting
Education and Training
Liberty University Lynchburg, VA Expected in 05/2016 Bachelor of Science : Interdisciplinary Studies - GPA :

Bachelor of Science in Interdisciplinary Studies with concentrations in Business Administration, Natural Science, Information Management Technology & Criminal Justice


National Healthcare Association

  • Certified Billing and Coding Specialist (CBCS) - 2016 to 2018
  • Certified Medical Technologist (MT) - 2016 to 2018
  • Certified Pharmacy Technician (CPhT) - 2016 to 2018
  • Certified Electronic Health Record Specialist (CEHRS) - 2016 to 2018
  • Certified Medical Administrative Assistant (CMAA) - 2016 to 2018
Northwell Health - Senior Medical Billing Specialist
Bethpage, NY, 11/2017 - Current
  • Utilized various security techniques to maintain confidentiality of client data.
  • Applied HIPAA privacy and security regulations while handling patient information.
  • Communicated with insurance representatives to complete claims processing or resolve problem claims.
  • Contacted insurance providers to verify insurance information and obtain billing authorization.
  • Interpreted medical terminology and pharmacological information to translate information into coding system.
  • Trained new team members on company policies and accounting systems to keep team operations productive and efficient.
  • Collaborated with multi-disciplinary staff to improve overall patient care and response times.
  • Maintained communication and transparency with governing boards, department heads and medical staff.
  • Maintained awareness of government regulations, health insurance changes and financing options.
VA Commonwealth University Health System - Pre-Authorization & Referral Representative
City, STATE, 05/2017 - 11/2017
  • Took billing calls, questions and concerns from patients and third party carriers.
  • Processed claims and forwarded information to Medicare, Medicaid and commercial insurance companies.
  • Entered patient charges and payments into electronic health records.
  • Identified discrepancies and carrier issues regarding billing and reimbursements.
  • Corrected, completed and processed claims for payer codes.
  • Protected medical office operations and integrity by keeping patient information confidential.
  • Oversaw daily collections and accounts receivable activities, developing robust strategies to maximize collections and reduce aged accounts.
  • Answered customer questions to maintain high satisfaction levels.
  • Managed all payments processing, invoicing and collections tasks.
  • Checked claims coding for accuracy with ICD-10 standards.
CVS Pharmacy Health - Pharmacy Technician
City, STATE, 07/2016 - 05/2017
  • Assisted pharmacist with clearing high volume of prescriptions and responded to customer questions.
  • Teamed with peers, technicians and pharmacists to prioritize and complete orders.
  • Created new customer profiles and updated demographics, allergies and new medications in pharmacy computer systems.
  • Maintained pharmacological practices by checking drug inventory, stocking medications and monitoring supplies.
  • Interpreted and processed medication orders under supervision of pharmacist.
  • Received and verified daily incoming drug inventories, reported discrepancies and logged items into inventory system.
  • Liaised with pharmacist to measure and prepare medication doses and packaging and label prescriptions.
  • Transmitted claims to insurance companies for payment and reconciled EOBs.
  • Promoted supplement and nutritional products to maximize sales and customer wellness.
  • Monitored supply inventory and promptly submitted replenishment orders to prevent shortages.
Richmond City Social Services - Program Specialist & Social Worker
City, STATE, 10/2014 - 07/2016
  • Coordinated benefits processing, including enrollments, terminations and claims.
  • Provided assistance to plan participants by explaining benefits information to ensure educated selections.
  • Communicated effectively via email, phone and face-to-face with plan participants to resolve issues pertaining to health and welfare benefits.
  • Mastered state and Federal benefit laws Including ERISA, FMLA, COBRA, HIPPA and 401k administration.
  • Evaluated efficiency and value of current benefit programs and made recommendations for improvement.
  • Assisted with audits by preparing accounts and providing information.
  • Kept operations in compliance with requirements by applying knowledge of applicable regulations, legal statutes and tax code information.
  • Implemented social service interventions to achieve treatment goals and address client needs.
  • Interviewed clients individually and in family groups to determine services to best address specific needs.
  • Referred patients to community resources for mental health treatment, child protective services and assistance for people with developmental disabilities.

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Resume Overview

School Attended

  • Liberty University

Job Titles Held:

  • Senior Medical Billing Specialist
  • Pre-Authorization & Referral Representative
  • Pharmacy Technician
  • Program Specialist & Social Worker


  • Bachelor of Science

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